Nurse Shortage and Nurse Turn-Over: Cause and Effect

Nurse shortage happens when the demand for professional nursing practitioners, such as registered nurses, exceeds their supply. On the other hand, nurse turnover explains the tendency of nursing employees to leave their jobs both voluntarily and involuntarily (Cox, Willis, & Coustasse, 2014). It is worth noting that the nurse shortage and turnover have critical and undesirable outcomes in the nursing profession. Notably, healthcare employers realize the great loss through the disruptions and poor quality patient care resulting from the shortage and the turnover (Cox, Willis & Coustasse, 2014). The nurse shortage and turnover present a critical issue for nursing leaders and managers. Therefore, by analyzing the approaches that the nurse leaders and managers would embrace in resolving the issue of the nursing shortage and nurse turnover, possible alluring employment schemes would be found and later employed to increase the number of caregivers in the healthcare sector.

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It is worth appreciating that nurse turnover has its advantages and disadvantages, especially for any organization. Good turnover occurs when the employee gets fired by the management, while bad turnover ensues when a well-behaved and desirable nurse resigns from his/her position. Consequently, the nurse turnover issue has a direct impact on the performance and profitability of healthcare organizations. Although “leadership” and “management” are often used interchangeably, both names carry different meanings as applied to the nursing profession. Huber (2013) avers that not every nurse manager portrays traits of a practical nurse leader, and nursing leaders are not necessarily good managers. Notably, a nurse manager has an assigned role in the organizational hierarchy and participates actively in decision-making. In contrast, a leader may not have recognized roles or powers within the organization (Huber, 2013). In fact, a leader is often defined by the power of the individual to influence others through interpersonal skills and communication. Accordingly, nurses might demonstrate leadership skills at all levels of experience and stages of career development.

Furthermore, to resist the tendency of nurse turnover and shortage, leaders should develop an effective understanding of the work environment within which the nurses operate (Butts, Bandhauer, & Rich, 2013). Through this understanding, the leaders should discover the issues affecting the nursing practitioners, including the high turnover rates or the shortage. Therefore, an unofficial frontrunner should communicate with any particular nurse before deciding to leave. In addition, the mentorship skills acquired will position a nurse leader strategically to share insights and knowledge that would be valuable to fellow nurses, hence lowering the rate of nurse turnover. Besides, leaders rely on critical thinking and the ability to envision a positive future (Butts, Bandhauer, & Rich, 2013). Accordingly, the mentors also employ the principles of inspiring, motivating, and empowering others to influence their decisions.

Similarly, nurse managers have critical roles in handling the issue of nurse turnover and the nursing shortage because they possess the power to influence decisions and organizational processes, hence the responsibility of addressing the issue. Moreover, just as leaders, managers also rely on critical thinking and the ability to visualize a positive future while addressing the nursing shortage and nurse turnover (Butts, Bandhauer, & Rich, 2013). Again, effective nurse managers are empowered through skills to coordinate resources in the form of personnel and finances to meet the goals and objectives of the organization. Indeed, control as a key element in the duties of the nurse manager enables him/her to employ reward and punishment effectively in tackling the issue of the nursing shortage and nurse turnover.

Notably, various principles guide the roles of nursing management. First, evidence-based management practices are critical doctrines that encroach on decision-making. Accordingly, the manager would employ research to improve the working environment to overcome the challenges of the nursing shortage and the turnover rates. Therefore, nursing managers are expected to improve the healthcare working environment for the nurses through the following ways. Firstly, managers should balance the tension between effectiveness and efficiency. Secondly, the managers can create and enforce trust among the working nurses. Thirdly, the managers are obliged to handle the process of change in the organization. More practically, the managers should create a learning environment and involve the other nursing personnel in work design and decision-making processes (Butts, Bandhauer, & Rich, 2013).

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Therefore, these ways are considered critical and effective in addressing the nursing shortage and nurse turnover concerns. Principally, the managers are expected to merge the disciplines of labor relations, human relations, and personnel management to administer nursing shortages or nurse turnover effectively. Besides, managers must harness critical skills such as communication, motivation, and leadership to address healthcare issues effectively (Butts, Bandhauer, & Rich, 2013). Finally, the recruitment and hiring process would require that the manager ensures that the organization acquires a skilled and motivated nursing workforce to counter high turnover rates and nursing personnel shortages.

According to the “Novice to expert theory,” leaders in the nursing field would appreciate the gradual learning process and the five critical competencies of nursing practitioners (Butts, Bandhauer, & Rich, 2013). In fact, novice, advanced, beginner, proficient, competent, and expert skills are developed over time. Accordingly, the leaders would approach the issue of the nursing shortage and turnover for the nurses from the five levels scheme to develop an accommodating system for future practitioners. Besides, the leader would utilize independence in decision-making, his/her skills in solving problems, and critical thinking to influence change within the organization as guided by the novice to expert theory.

Finally, leaders would approach the nursing shortage and nurse turnover issue through diversity in leadership styles. For instance, to counter the challenge of increased turnover, transactional leaders would use rewards to attract and retain nurses (Giltinane, 2013). Likewise, for transformational leaders, identifying the nurses’ strengths and building on the self-esteem aspects would work to overcome the challenge of personal satisfaction in nursing. As such, leaders who exhibit situational leadership traits would also best handle particular situations (Giltinane, 2013). For instance, with the rampant loss of employees, situational leaders would address the issue through contingent measures influenced by the prevailing circumstances.

From a subjective position, any person at the management level would need to exhibit definite leadership traits. Through such personalities, the manager, like the leader, should address the nursing shortage and the high rates of nurse turnover by guiding the aspects of the theory. Therefore, the philosophy of everyone being a personal leader would break out the above argument. Accordingly, instead of a practicing nurse leaving the current occupation because of manageable issues, one would employ the skills learned in the developmental stages outlined by the novice to expert theory and understand that all matters arising would always have a solution. In essence, the high rates of nurse turnover and the overall nursing shortage would be handled through improved interpersonal relations and a personalized approach to maintaining the nursing discipline.



Butts, J. B., Bandhauer, D., & Rich, K. L. (2013). Philosophies and theories for advanced nursing practice. New York: Jones & Bartlett Publishers.

Cox, P., Willis, W. K., & Coustasse, A. (2014). The American epidemic: The US nursing shortage and turnover problem. Medical Specialties Commons,1-12

Giltinane, C. L. (2013). Leadership styles and theories. Nursing Standard, 27(41), 35-39.

Huber, D. (2013). Leadership and nursing care management. St. Louis, Missouri: Elsevier Health Sciences.

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